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Sleep disturbances

Dr. Christine Maheu, RN, PhD

Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.

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Ms. Rosemary Cashman

Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.

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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital

Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.

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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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Over half of all cancer patients will experience some form of sleep disturbance.1 Stress, anxiety and depression may also contribute to sleep problems. In turn, sleep problems may exacerbate psychological distress and add to fatigue. Cancer treatments may alter the usual patterns of sleep. For example, those undergoing cancer treatment may require naps in the day. Cancer-related fatigue may not respond to rest the way normal fatigue does, with the result that cancer survivors may always feel low energy and easily become tired.2 Knowing your patient’s sleep patterns and needs for rest will help you develop a better return to work plan. To help your patient track their sleeping patterns, you may want to refer them to the Pittsburgh Sleep Quality Index self-assessment tool.3

Vocational implications

Sleep difficulties may add to fatigue. Some patients may have difficulty waking in the morning and thus may need to start work later. Taking sleep medications can make some people feel “foggy” in the morning. Poor sleep can affect concentration, memory, energy and emotions making the demands of work more challenging.

What patients can do

Sleep hygiene techniques are simple things patients can do to improve their sleep without using sleep medications. Advise patients to consult their physicians if problems with sleeping become chronic or impact their function or wellbeing.

The following resources can help patients manage sleep problems:

Job accommodations

Modify work schedules:

  • Use flexible work hours to accommodate low-energy times of day.
  • Change shifts to fit the patient’s highest daily energy levels.

Modify work environments:

  • Set up a resting room, bring in a couch, or store a cot for employees to nap or rest during breaks or lunch.

Workplace changes and strategies to handle fatigue will also help with sleep disturbances.

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